Emergency Medicine Department, Naval Medical Center Portsmouth, VA.
Ann Emerg Med. 2013 Dec;62(6):616-626.e8. doi: 10.1016/j.annemergmed.2013.05.026. Epub 2013 Jul 3.
Life-threatening warfarin-associated hemorrhage is common, with a high mortality. In the United States, the most commonly used therapies--fresh frozen plasma and vitamin K--are slow and unpredictable and can result in volume overload. Outside of the United States, prothrombin complex concentrates are often used instead; these pooled plasma products reverse warfarin anticoagulation in minutes rather than hours. This article reviews the literature relating to warfarin reversal with fresh frozen plasma, prothrombin complex concentrates, and recombinant factor VIIa and provides elements for a management protocol based on this literature.
危及生命的华法林相关出血很常见，死亡率很高。在美国，最常用的治疗方法——新鲜冷冻血浆和维生素 K——起效缓慢且不可预测，并且可能导致血容量过多。在美国以外，通常使用凝血酶原复合物浓缩物；这些混合血浆产品可在数分钟内逆转华法林的抗凝作用，而不是数小时。本文综述了与新鲜冷冻血浆、凝血酶原复合物浓缩物和重组因子 VIIa 逆转华法林抗凝作用相关的文献，并根据这些文献提供了管理方案的要素。
